Self-reported health impacts of do-it-yourself air cleaner use in a smoke-impacted community

Background Smoke exposure from wildfires or residential wood burning for heat is a public health problem for many communities. Do-It-Yourself (DIY) portable air cleaners (PACs) are promoted as affordable alternatives to commercial PACs, but evidence of their effect on health outcomes is limited. Objective Pilot test an evaluation of the effect of DIY PAC usage on self-reported symptoms, and investigate barriers and facilitators of PAC use, among members of a tribal community that routinely experiences elevated concentrations of fine particulate matter (PM2.5) from smoke. Methods We conducted studies in Fall 2021 (“wildfire study”; N = 10) and Winter 2022 (“wood stove study”; N = 17). Each study included four sequential one-to-two-week phases: 1) initial, 2) DIY PAC usage ≥8 h/day, 3) commercial PAC usage ≥8 h/day, and 4) air sensor with visual display and optional PAC use. We continuously monitored PAC usage and indoor/outdoor PM2.5 concentrations in homes. Concluding each phase, we conducted phone surveys about participants’ symptoms, perceptions, and behaviors. We analyzed symptoms associated with PAC usage and conducted an analysis of indoor PM2.5 concentrations as a mediating pathway using mixed effects multivariate linear regression. We categorized perceptions related to PACs into barriers and facilitators of use. Results No association was observed between PAC usage and symptoms, and the mediation analysis did not indicate that small observed trends were attributable to changes in indoor PM2.5 concentrations. Small sample sizes hindered the ability to draw conclusions regarding the presence or absence of causal associations. DIY PAC usage was low; loud operating noise was a barrier to use. Discussion This research is novel in studying health effects of DIY PACs during wildfire and wood smoke exposures. Such research is needed to inform public health guidance. Recommendations for future studies on PAC use during smoke exposure include building flexibility of intervention timing into the study design.

Impact/Purpose

This journal article describes the results of a study evaluating the real-world effectiveness of do-it-yourself (DIY) air cleaners to mitigate the negative health impacts of wildfire and wood burning smoke. The study took place in Hoopa, CA, which is a tribal community that is frequently subjected to wildfire smoke during the summer time and wood smoke in the winter time. Participants were asked to operate a DIY air cleaner, consisting of a MERV 13 filter attached to a box fan, and a commercial air cleaner in their homes for at least 8 hours a day. We monitored air cleaner usage and indoor/outdoor PM2.5 concentrations at participants’ homes throughout the study. We conducted phone surveys about participants’ health, perceptions, and behaviors. We used mixed effects multivariate linear regression to analyze health outcomes associated with air cleaner usage and conduct a mediation analysis of indoor PM2.5 as a mediating pathway. We found that DIY PAC usage was associated with small improvements in physical health during the wood stove exposure period. However, the mediation analysis did not indicate that those associations were attributable to changes in indoor PM2.5 concentrations.  This research is novel in studying the health effects of DIY PACs during periods of wildfire and wood smoke exposure. Exploring the efficacy of DIY PACs to protect health during smoke exposures is critical in informing public health guidance for protecting the health of communities that disproportionately experience wildfires and/or have limited access to central heat.    

Citation

Turner, M., P. Prathibha, A. Holder, A. Rappold, B. Hassett-Sipple, B. McCaughey, L. Wei, A. Davis, K. Vinsonhaler, A. Batchelder, J. Carlstad, AND A. Chelminski. Self-reported health impacts of do-it-yourself air cleaner use in a smoke-impacted community. Elsevier B.V., Amsterdam, NETHERLANDS, 10(4):e25225, (2024). [DOI: 10.1016/j.heliyon.2024.e25225]

DOI: Self-reported health impacts of do-it-yourself air cleaner use in a smoke-impacted community